NC
N C

1 reviews | Active since Apr 2019

04 Oct 2019, 18:33

No formulary

I am considering changing my current medical scheme to Bestmed medical scheme. But I am encounting a bit of a problem. The new membership department is very good but they are unable to advise me if the current approved PMB and CDL conditions that we have with our current medical scheme will be covered with Bestmed as well as the associated medications, because there is apparently no formulary. The new membership department did advise me to speak to another department but they too were clueless.

Bestmed medical scheme needs to give their new membership department all the relevant information they require so that they can disclose this to prospective new members.

0
Replies (3)
Bestmed Medical Scheme
Bestmed Medical Scheme's reply05 Oct 2019, 08:34
Official
Good day

Can you kindly indicate for which PMB/CDL conditions you are currently registered and the names of the medication you are currently using?  We would also have to know for which option you will be registering as the medicine formularies differ per option.

With kind regards.

Bestmed
Bestmed Medical Scheme
Bestmed Medical Scheme's reply05 Oct 2019, 10:20
Official
Good day Mr Cranston

Xarelto 20mg is not on the Scheme's medicine formulary for CDL conditions.  However, it may be authorized by the Scheme as a non-formulary item which means there may be a co-payment payable from your side towards the item - depending on your final choice of option.

With kind regards.

Bestmed


NC
N C's update05 Oct 2019, 10:38
Reviewer Update
Thank you for your response. Currently we don't have a co pay because it's a PMB condition and there is no other suitable treatment, therefore our scheme has to cover in full. So I'll stay with my current scheme for now.